Gesetzliche

Gesetzliche Krankenversicherung

Die gesetzliche Krankenversicherung ist ein Bestandteil des Gesundheitssystems in Deutschland. Die Beiträge für die Krankenversicherung erhält der Arbeitnehmer nicht ausbezahlt; sie werden direkt mit den Beiträgen zur Arbeitslosen-, Renten- und Pflegeversicherung vom Arbeitgeber an die zuständige Verteilerstelle überwiesen. Seit 2009 ist dies der Gesundheitsfonds. Die Beiträge für die Krankenversicherung bezahlen Arbeitnehmer und Arbeitgeber anteilig; das gilt auch für Rentner, die ihre Rente von der Deutschen Rente beziehen.

Auch wenn der Krankenkassenbeitrag bei allen gesetzlichen Krankenversicherungen derselbe ist, gibt es doch verschiedene Arten der Krankenkassen. Diese sind

• Ersatzkassen (EK)
• Allgemeine Ortskrankenkassen (AOK)
• Betriebskrankenkassen (BKK)
• Innungskrankenkassen (IKK)
• Landwirtschaftliche Krankenkassen (LKK) und
• Knappschaft.

Pflichtversicherung

Bei diesen Krankenversicherungen kann sich jeder Arbeitnehmer pflichtversichern; Minijobber sind automatisch bei der Deutsche Rente Knappschaft zur See versichert.

Leistungen

Die gesetzlichen Krankenversicherungen sind verpflichtet, die Kosten für die medizinische Versorgung ihrer Mitglieder und deren Angehöriger zu übernehmen. Eine ausführliche Beschreibung ist im SGB V zu finden. Der Umfang der verschiedenen Leistungen bestimmen die §§ 2 Abs. 1 und 12 SGB V sowie § 92 SGB V. Der Leistungskatalog der gesetzlichen Krankenversicherungen wird kontinuierlich überarbeitet. Derzeit enthält dieser Katalog Leistungen zur Verhütung, Früherkennung und Behandlung von Krankheiten. Die einzelnen Leistungen sind auf den Websites der gesetzlichen Krankenversicherungen enthalten. Neben den gesetzlich verankerten Leistungen können Mitglieder auch Wahlleistungen buchen.

Wechsel der Krankenversicherung

Jede Person hat die freie Wahl der Krankenversicherung, in der er versichert sein will. Bei einem Wechsel der Krankenversicherungen kommt allerdings § 175 Abs. 4 SGB V zum Tragen. Dieser Paragraf besagt, dass ein Mitglied einer Krankenkasse frühestens nach einer Mitgliedschaft von 18 Monaten die Mitgliedschaft mit einer Frist von zwei Monaten kündigen kann.

 

Zusatzbeiträge

Erhebt die Krankenversicherung jedoch Zusatzbeiträge oder erhöht die bisher geforderten Zusatzbeiträge, kann das Mitglied von seinem Sonderkündigungsrecht Gebrauch machen.
Die Kündigungsfrist verlängert sich, wenn das Mitglied der Krankenversicherung einen Wahltarif mit weiteren Konditionen nutzt. Die Verlängerung der Kündigungsfrist beträgt ein Jahr, maximal jedoch drei Jahre.

Arten der Mitgliedschaft

Mitglieder einer gesetzlichen Krankenversicherung sind in erster Linie die Beitragszahler. Diese sind versicherungspflichtige Arbeitnehmer und Rentner sowie freiwillig Versicherte. Ebenfalls Mitglied der GKV, jedoch kein Beitragszahler sind Angehörige von Mitgliedern, die über die kostenlose Familienversicherung versichert sind.
Wer versicherungspflichtig ist, ergibt sich aus § 5 SGB V und § 2 KVLG 1989. Dies sind in der Regel Arbeitnehmer und Rentner, deren Einkommen unterhalb der Beitragsbemessungsgrenze liegt. Seit Januar 2009 sind alle Bürger in Deutschland aufgefordert, sich bei einer Krankenversicherung ihrer Wahl anzumelden, sofern sie nicht krankenversichert sind.

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